NPI | 1700506532 |
---|---|
Entity Type | Organization |
Authorized Contact | MARC EXILUS Owner 302-722-4740 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
261Q00000X Clinic/Center | |
Enumeration Date | 2022-08-31 |
Last Update Date | 2024-03-05 |